Catheter mechanoprophylaxis against Candida species

<i>Candida</i> species infection of vascular and urinary catheters is a growing clinical concern. By understanding how biomaterial physicochemical surface properties affect fungal behaviour, catheters could be designed to mechanically discourage infection as a form of 'mechanoprophylaxis'. In this study, silicone surfaces were synthesized with 'stiff' or 'soft' mechanical properties and the subsequent adherence, proliferation and biofilm production of <i>Candida albicans</i>, <i>Candida parapsilosis</i> and <i>Nakaseomyces glabratus</i> isolates on these surfaces were analysed. <i>Candida</i> significantly bound more, proliferated more and produced more biofilm on softer silicone surfaces. Importantly, the observed differences in fungal adhesion and biofilm formation between catheter surface types persisted when surfaces were pre-coated with host serum proteins. This study demonstrated that catheter synthesis parameters can affect physical properties and subsequent susceptibility to fungal colonization. These data lay important groundwork in exploiting mechanical design to decrease the ability of <i>Candida</i> to colonize devices and thus prevent medical device infections.